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Pedestrians walk near the India Gate monument in New Delhi amid heavy smog on Oct. 27, 2017. (Dominique Faget/AFP/Getty Images)

Only about a year ago, millions of Indian residents and visitors were choking on hazardous air in Delhi and northern India. The government had (finally) declared a public health emergency, schools and offices were closed, and even the healthiest individuals were feeling sick. Weather patterns, smoke from regional crop burning, and unabated Diwali fireworks-burning contributed to the horrific downturn in already-unhealthy air quality.

Now, as the harvest and holiday season arrives in the next several weeks, we must ask, will the air be any better this year?

There are no indications that air quality will improve in the coming months. Factors such as weather patterns are out of our control. We have yet to see the large-scale changes in vehicle and industrial emissions required for cleaner air. Government and health authorities lack assurances to prevent another air pollution crisis. (The Supreme Court of India is in fact hearing litigation arguing to cancel last year’s Diwali fireworks ban.) Compared to a year ago, we continue to fight and hope for clean air, but question whether air quality will meaningfully improve.

The upcoming “air pollution season” coincides with peak travel season to India. Very few travel sites describe air pollution as a health risk for India-bound travelers. Unlike mosquito-, food-, or water-borne illnesses, you cannot prevent the exposure that causes air pollution-related harm. Simply breathing will expose you to air pollution particles with known effects ranging from respiratory symptoms to serious systemic illness and even death.

Larger pollution particles irritate your respiratory passages, leading to symptoms of nasal congestion, sore throat, and/or cough. Microscopic pollution particles, known as PM2.5, lodge deep into your lungs and spread through the bloodstream into other organs of your body, from your heart to your kidneys and/or brain. Any level of PM2.5 exposure is harmful, especially if you are very young or elderly, or have underlying chronic diseases. Prolonged exposure adds to risk for illnesses such as cancer or dementia, which may emerge years or decades later.

Despite these known risks, many of us will need to and/or choose to travel to India this year. If so, we need to at least try to protect ourselves from air pollution-related harm. If you are traveling to India for the holidays, a wedding, or simply to visit home, here are some steps you can take to mitigate the risk for yourselves and your family.

1)   Be aware of the air quality during your travels. Knowing the air quality measurements in your locality can help you plan and adjust your outdoor and other activities. There are several air quality monitoring sites you can refer to before and while you travel, including city- and neighborhood-specific measures at <aqicn.org> and India-wide measures through the U.S. Embassy < https://in.usembassy.gov/embassy-consulates/new-delhi/air-quality-data/>.

2)   Get immunized against seasonal influenza, before you leave. Acquiring influenza infection in poor air quality conditions could result in even worse symptoms, illness, and complications.

3)   Use an N99 mask to reduce your exposure. Cotton masks provide relatively greater comfort and durability/washability. N99 masks are now widely available in Indian cities or online, but consider bringing one with you, so you can wear it as you leave the airport.

4)   Consider taking your own over-the-counter medications such as a nasal allergy spray, an antihistamine, and/or a decongestant, to help reduce pollution-related respiratory symptoms. With your health care provider, make sure these medications are okay to take with your current medicines or medical conditions, and plan for when and how to use them. The U.S. CDC has a traveler’s packing list that may help: < https://wwwnc.cdc.gov/travel/destinations/india/traveler/packing-list>.

5)   Try to spend time or stay in places with effective air purification systems. Try to maximize your time in clean air, and minimize your time in unhealthy air.

6)   Trust your instincts if you feel unwell. Air pollution does not just cause irritating respiratory symptoms - it can lead to heart attacks, stroke, and other serious and sometimes sudden respiratory and cardiovascular events. Seek prompt medical attention, especially if you are older or have pre-existing medical conditions, or for your children.

Indian residents and civil organizations, government, and health authorities are striving for policies and changes required to fight air pollution. Yet there is a very long way to go before India achieves clean air. In the meantime, as visitors to India, just like those who live there, we must consider the risks, plan ahead, and do our best to protect ourselves and our loved ones, no matter how long our stay.

Gita Sinha

Physician

Via e-mail

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